Stepping on the grounds of my birthplace after 23 years was a shocking experience. The images of poverty, destruction and desperation around me was quite different from the images of my childhood memories. Immediately, I begin to have mixed feelings of guilt for being more fortunate than others in this country as a child, at the same time blessed for the opportunities I have as a United States citizen. Within hours of arrival at the tent hospital, we had two emergent cesarean cases rushed though the operating room doors. …

From April 10 to 18, Children’s Hospital Boston sent a group of 26 clinicians to a field hospital in Haiti. Here, those who staffed the pediatric wards reflect on their experience.

Grace Chan MD, Boston Combined Residency Program

On our first day, a young woman came in with new onset seizures. She presented with all the signs of increased cranial pressure that I learned about as a medical student – obtunded, signs of cushings triad – bradycardia and hypertension. We gave mannitol, steroids, hypertonic saline. I didn’t think she would survive. Did she have meningitis, cerebral malaria, a tumor? We don’t know, but several days later she was walking, talking and close to baseline. Here, diagnosis isn’t as important as management. …

From April 10 to 18, Children’s Hospital Boston sent a group of 26 clinicians to a field hospital in Haiti. Here, those who staffed the ICU reflect on their experience.

Elizabeth Robertshaw, RN, BSN, CCRN, 7 south MSICU

Where to begin? How do you write on paper a whole country’s suffering? How do you show their faith, courage, and thankfulness through words? It has been so difficult to express all the emotions I have experienced in the past few weeks. Highs and lows. …

Clinicians working in high-resource settings, like Children’s Hospital Boston, rely on the availability of certain equipment to do their jobs, like ventilators, specially sized needles and tubes and a fully stocked pharmacy. But when they’re forced to perform without their gear—like in Haiti in the immediate aftermath of the January earthquake—many find it bewildering and even paralyzing. “We fall into these patterns of providing care,” says David Mooney, MD, MPH, director of the Trauma Program, who was one of the first medical responders to respond after the disaster. “One of the things I noticed in Haiti was that many doctors really fixated on what they didn’t have.”

That mental block can waste time and be counterproductive, so Children’s is developing a training program to prepare the doctors, surgeons, nurses, pharmacists and other volunteers who are going to Haiti to continue relief efforts in the coming months for the conditions they’re likely to find. Mooney, along with Shannon Manzi, PharmD, and Debra Weiner, MD, PhD, worked with Children’s Simulator Program to create the special training, in which clinicians reenact challenging situations on robotic mannequins. Peter Weinstock, MD, PhD, director of the Simulator program, hopes that by practicing in an environment with limited supplies, clinicians will be encouraged to think outside of the box to find the resources they need, and will be better prepared for a disaster zone.